Provider Demographics
NPI:1932641222
Name:EL-SARRAF, WALEI-EL-DIN ADHAM (PHARMD, CPE, BCACP)
Entity Type:Individual
Prefix:DR
First Name:WALEI-EL-DIN
Middle Name:ADHAM
Last Name:EL-SARRAF
Suffix:
Gender:M
Credentials:PHARMD, CPE, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FOUNTAIN PLZ STE 1440
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-2215
Mailing Address - Country:US
Mailing Address - Phone:716-961-3266
Mailing Address - Fax:
Practice Address - Street 1:50 FOUNTAIN PLZ STE 1440
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-2215
Practice Address - Country:US
Practice Address - Phone:716-961-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2021-12-17
Deactivation Date:2017-09-28
Deactivation Code:
Reactivation Date:2018-01-11
Provider Licenses
StateLicense IDTaxonomies
NYI061560183500000X
COPHA.0020661183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist